Adhesions following abdominal surgery have plagued surgeons for years. Intra-operative irrigation of the peritoneal cavity with isotonic saline solution is a common procedure in gastrointestinal surgery. Although warm saline is often recommended to prevent hypothermia, accurate temperature control is rarely observed. Recent experimental studies are correlating saline temperature with adhesion formation and it has been shown that when saline temperature exceeds 37,0ºC it increases the possibilities of adhesions. Hypothermia is frequent during laparoscopy due to the insufflation of cold carbon dioxide to induce pneumoperitoneum. Most laparoscopic procedures also use irrigation with physiologic solutions, such as normal saline. Our purpose was to evaluate the influence of intraperitoneal isotonic saline solution irrigation, at different temperatures, on adhesion formation and hypothermia prevention after pneumoperitoneum. Eighty rats were divided in four groups of 20 animals each: control group (G1) with no irrigation, G2 group with irrigation at ambient temperature - 22,0°C, G2 at 35,0ºC and G4 at 45,0ºC. Temperature analysis was accomplished through a rectal probe in three different moments: after anesthesia (T1), five minutes after carbon dioxide insuflation (T2) and five minutes after saline irrigation (T3). The animals were sacrificed in the 28th day of postoperative. Adhesions were observed in all groups with irrigation and a greate adherence formation (30%) was observed at 45,0ºC. Even so, this difference was not significant. In the G2 a significant fall occurred in the rectum average temperature when compared with the other groups demonstrating that the hypothermia can be avoided with the use of warmed saline solution in laparoscopic surgery.
Adhesion; Laparoscopy; Hypothermia
